Individual ProviderAlyssa KellyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3599 University Blvd S, Jacksonville, FL 32216-4252(904) 345-7600(914) 907-0632PECOS EnrollmentBased on the most recent information from CMS, provider Alyssa Kelly does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1740793264Provider TypeIndividualFull NameKelly, AlyssaGenderFemaleSole ProprietorNoEnumeration Date11/6/2017Last Updated11/6/2017Contact InformationPractice LocationPractice Address3599 University Blvd S, Jacksonville, FL 32216-4252Phone(904) 345-7600FaxUnlisted FaxMailing LocationMailing Address13444 Gran Bay Pkwy Apt 523, Jacksonville, FL 32258-7421Phone(914) 907-0632FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT33152Florida